<<Disclaimer: Verify this information before applying it to your situation.>> Dear Betsy, As I understand it you have a girl who 1. Is entering puberty, 2. Is at risk of low calcium due to diet, 3. Is possibly (but not confirmed) celiac, 4. Has bone pain, quite severe. You do not indicate whether the pain is associated with a joint or muscle insertion, or a specific bone. Is it worse or does it localise on exercise? You seem to indicate that she has pain when she sleeps. Have you seen a paediatrician? In my opinion, Growing pain can be quite localised, and due to specific attachments on specific bones (you may feel a lump below the knee that doesn't correspond to one on the other knee), or a little generalised. The mechanism is thought to be increased force during exercise against growing portions (the end plates) of long bones. [More informed comment from other readers is appreciated here!] Stress fractures can be associated with calcium depletion or with heavy exercise, and would be localised. In both cases things are worse with exercise. In the second case paediatric advice is required. (Why the calcium depletion?) Many celiacs report a degree of arthritis - reportedly often in a single joint. Generalised bone pain, noticed at night is not a feature that I have read about in celiac. There are many other causes of bone pain and in a youngster many of these are difficult to diagnose, and require expertise. If you have not seen a paediatrician I suggest you do so.